Many of my students have difficulties telling stories. When looking at a book together, even books they love and have seen many times, they often struggle to understand what they are reading and cannot therefore retell the story in any sequence. A great method I often use with those students is called Colourful Semantics.
What is Colourful Semantics?
Colourful Semantics is an approach aimed at helping children develop grammar and meaning of phrases and sentences. We help children identify WHO is the subject in a story, what is he/she/it DOING to WHAT and WHERE. There are lots of colour coded stages but we tend to start with the basic 4:
WHO = ORANGE
DOING = YELLOW
WHAT = GREEN
WHERE = BLUE
Once a student is accomplished at this level, we move on to different colour codes for describing words (adjectives), connecting words (with/together/and/therefore) feeling words (PINK), timing words (BROWN) eg. when, tomorrow, last week etc.
Colourful Semantics is a really useful method and helps children to organise their sentences. It also helps me knowing how to guide a student in thinking about the story.
The approach can be used with children with a range of Speech and Language Needs, such as:
Developmental Delay / Disorder
Autistic Spectrum Condition
Down Syndrome
Any other syndromes and related speech and language delays
General Literacy difficulties
There are a wide range of benefits to using this approach and I use it in my therapeutic work with children of around 3 years plus. Below is a little video which shows how I use it with this student who has general language difficulties associated with Autism. One of the main benefits with this student is that seeing the Cue Cards helps her to use a much wider range of vocabulary than she would ordinarily generate. Her sentences are getting longer and she is more able to answer questions. In general, I find it useful to help with storytelling and to guide us through the story in a sequence.
There are many on-line games these days that have incorporated the Colourful Semantics Approach. Once a child is familiar with the basic colour scheme then gradually the visual prompts can be reduced to using verbal prompts.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
We all have the right and want to express thoughts, feelings, and needs. For non-speaking or minimally speaking children, finding an avenue to communicate effectively can be a challenging journey. Parents are often at a loss as to where to start. Sometimes a little bit of Makaton signing has been used here and there but we mostly find that gradually signing fades as parents feel that it just doesn’t seem to get copied and used by the children.
They live and breathe their system
This is where we need to pick up the pieces and start again: because all successful families where children start using their boards or their electronic AAC (Augmentative and Alternative Communication) systems do this one thing: THEY LIVE AND BREATHE THEIR SYSTEM.
They have boards in every single room of the house;
They have a board in the car, attached to the side of car door so their child can point to it as they need to;
They have a smaller board in their handbag/rucksack when out and about;
They have a board for shopping and attach it to the shopping trolley;
They are never ever without their board.
Because they realise that a child should never be without their mouths to speak, should never be without a means to speak. They use their own board to model and the child has always access to their board to model back or to just look.
This is where success begins
Success begins at consistent and joyful use of the board/AAC system throughout the entire day. If we think about it, doesn’t it make sense? Of course, it does! We talk to our child for the first two years of their life continuously wherever we are and our child is continuously encouraged to use their mouths for talking in all situations.
Same goes for Signing: Makaton or any other sign system is a very powerful means to aid communication and I certainly advocate and use it in practice. Though much like words, signs are very elusive and temporary—as soon as the sign has been made it is gone and no longer present. Same with words of course. This can be difficult for people who need longer to process information.
The beauty of symbols or photographs is that they are permanent: they don’t vanish, they stay and with the core board they stay in the same place! This is very reassuring. We can learn where a symbol is and we can be assured that it will still be there the next time we look at the board.
It has 48 cells and we can see the most frequently used core words on here, words that we use 80% of the day when talking with our non-speaking/minimally speaking children, younger children and children with cognitive delay. We keep our sentences short and we say phrases pertaining to their daily lives;
Let’s GET your toy
PUT it here, PUT it away, PUT it IN
Let’s READ a book
UP you get
WANT some MORE?
That’s GOOD isn’t it?
Let’s OPEN the box and LOOK
And so on… All these phrases can be aided with the above board. Your child will learn OVER TIME and OVER CONTINUOUS USE where GET/PUT/MORE/WANT/IN—where these symbols are. For children who are slow to process this is so helpful, to have a visual representation of what has just been said. It aids understanding in the first place. Gradually as a child starts to copy they will point to powerful symbols themselves and if they want to speak they can also speak of course:
A child might point to WANT + MORE and then say with their mouths: BANANA!
Board examples
Here are some other boards I have made specifically for daily situations and preferences of some of my students. Here is one for toileting:
And another one:
These boards incorporate high-frequency and versatile words, enabling us to make little sentences.
Building Language and Literacy Skills
AAC Core Boards are not just tools for immediate communication. They also play a pivotal role in language and literacy development. By using these boards, non-speaking children engage with words and symbols, reinforcing their understanding of language structure and grammar.
Over time they naturally absorb language patterns, laying the foundation for improved literacy skills.
Customisation for Individual Needs
Every non-speaking child is unique, and their communication needs can vary significantly. AAC Core Boards are designed with this diversity in mind. The boards can be adapted to include specific vocabulary relevant to the child’s daily life, interests, and activities. This personalisation ensures that the AAC Core Board is a true reflection of the child’s personality and needs, making communication more engaging and effective.
Collaboration between AAC Core Boards and Speech Therapy
While AAC Core Boards are an incredible tool, they are only used effectively by the non-speaking child when the board is used BY ALL COMMUNICATION PARTNERS around the child.
Again, I know I am being repetitive here, but the board needs to be used and modelled by the adults constantly in the first place and for a period of time before we can expect our children to take an interest and use the boards themselves. Think how long it typically takes for a child to learn their first word: around a year! During that time the adults talk constantly to their child without hesitation or expectation! The same goes for introducing this new way of communicating.
Collaborating with your child’s speech-language therapist (SLT) ensures that your child receives the right guidance in using the AAC system. SLTs can assess your child’s communication abilities, recommend appropriate boards and provide guidance on how to best implement them.
Conclusion
For non-speaking children, AAC Core Boards are bridges to their world.
These boards foster language development, social interaction, and personal expression. AAC Core Boards offer a beacon of hope, helping non-speaking children break through communication barriers and thrive in a world that is waiting to hear their voices. Boards are simple for anyone to use and understand. Have a go! You will be surprised how lovely it is to use a board with ease and once your child sees you do this, you have a chance for your child to start copying you…and express something! HOW ABOUT THAT! I look forward to hearing your stories!
The London Speech and Feeding Practice
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Have you heard the term ‘Container play’? I use this very often with children in my sessions as it is so versatile and an enjoyable activity that can be done in parallel with a child or together. Container play is a powerful tool for fostering development in young children, especially those with developmental delays. This seemingly mundane activity provides a rich environment for sensory exploration, motor skill development, and cognitive growth.
What is container play?
Container play involves children interacting with various containers—boxes, buckets, bowls, cups, various bags, etc.—and filling, emptying, and transferring objects within and between them. Objects can include literally anything: small beads, bead chains, table tennis balls, wooden pegs, dinosaurs or any other little person toy, blocks of varying sizes, sand, water, or any other safe material. Larger containers obviously take larger items: socks, stuffed animals, bigger balls, bigger blocks etc really the choices are endless.
Benefits for children with developmental delays:
Sensory exploration:
Touch: Children explore different textures and temperatures of containers and objects.
Sight: They observe how objects look inside and outside the containers, how light reflects off them, and how colours change.
Sound: They listen to the sounds of objects clinking, rattling, and splashing.
Proprioception: Filling and emptying containers helps develop body awareness and spatial awareness.
For neurodivergent children who might have sensory regulation difficulties, consider the following adaptions to accommodate your child’s sensory needs:
Over-stimulation: For children who are easily overstimulated, start with simple setups using a limited number of containers and objects. Gradually increase the complexity as they tolerate it.
Under-stimulation: For children who seek sensory input, provide a variety of textures and materials, such as sand, water, slime, or beans.
Temperature: Offer a variety of temperature options. Some children may enjoy warm water or cool sand.
Lighting: Adjust the lighting to create a calming or stimulating environment.
Focus on one sense at a time: Initially, focus on one sensory aspect, such as the feel of sand or the sound of water.
Weighted containers: Use heavy containers filled with rice or beans to provide deep pressure input.
Fidget toys: Incorporate fidget toys into the activity to provide sensory input and help with self-regulation.
Tactile exploration: Encourage exploration of different textures using objects with varying surfaces.
Pincer grasp: Picking up small objects helps develop fine motor skills like the pincer grasp.
Strength and dexterity: Manipulating containers and objects strengthens hand muscles and improves dexterity. Opening and closing containers can be a huge area of interest; how does the top screw back on, or off?
Cognitive development:
Cause and effect: Children learn that their actions (e.g., pouring water or sand) have consequences (e.g., the water spills).
Spatial awareness: They develop an understanding of concepts like inside, outside, full, empty, and over/under; also how big is the vessel and how much goes in before it’s full or spills over. How small is the vessel opening and what do I need to do to get the beads into the container.
Problem-solving: Children learn to solve problems, such as how to get an object out of a narrow container or how to transfer water without spilling.
Social and emotional development:
Communication: Container play can encourage communication as children interact with others, sharing toys and commenting on their actions. Asking for help to open and close a container is often a great opportunity to practise ‘help me’ or ‘open it’
Turn-taking: Sharing containers and materials helps children learn to take turns and cooperate.
Sensory regulation: For children with sensory sensitivities, container play can be a calming and self-regulating activity.
Tips for engaging children in container play:
Create a safe and inviting environment. A shower curtain on the floor makes things easier for tidy up afterwards. And it allows for spillages.
Provide a variety of containers: Use different sizes, shapes, and materials. Use containers that are visually interesting and pleasing, perhaps a festive biscuit tin, or a tin that looks like train engine. Use see-through containers at first which make the filling and emptying more obvious. This is important for children who have no previous experience with this type of play and need to ‘warm up’ to it. Once a child loves and is used to container play you can go wild with all types of containers.
Offer a variety of objects: Include balls, blocks, sand, water, and other age-appropriate materials.
Join in the fun! Start off the process, show your child what the joy of the activity is for yourself, how fun it is to fill and empty containers, provide enough containers for your child to start playing alongside you, and comment on their actions.
Follow your child’s lead: Allow them to explore and experiment at their own pace.
Adapt activities: Adjust the level of challenge based on your child’s abilities and interests.
Container play is a simple yet powerful tool that can support the overall development of young children, especially those with developmental delays. By providing a rich and engaging sensory experience, container play can help children build essential skills in motor, cognitive, social, and emotional domains.
If you have any questions or would like to have more in-depths demonstration of this or other play styles for your child please contact me.
I look forward to hearing from you.
Sonja McGeachie
Early Intervention Speech and Language Therapist
Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice
The London Speech and Feeding Practice
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
As a Speech and Language Therapist specialising in infant feeding, I often hear from worried mums describing their breastfed baby’s fussiness. ‘My baby is so burpy and gassy,’ ‘might it be reflux?’ or ‘she just seems uncomfortable after every feed’. While these concerns are incredibly valid and distressing for both baby and mum (and dads!), the underlying cause isn’t always what you might think. Often, the culprit isn’t primarily a digestive issue, but rather a mechanical one: how effectively your baby is managing air during feeding.
Many parents are told their baby has ‘colic’ or ‘reflux’ and are offered solutions that don’t quite hit the mark because they overlook a fundamental aspect of feeding: the suck-swallow-breathe sequence. Understanding this intricate dance can be the key to unlocking a calmer, happier feeding experience for your baby and you.
Understanding the suck-swallow-breathe sequence
Your baby’s mouth, tongue, jaw, and throat muscles work together in a precise rhythm like a beautifully orchestrated symphony. First your baby draws milk, then swallows it, and then takes a breath, all without interruption. This is the ideal suck-swallow-breathe (SSB) sequence.
When the SSB sequence functions optimally, a baby latches deeply, creates good suction, draws milk, swallows efficiently, and then pauses just long enough to take a gentle breath before the next suck. This smooth, coordinated process minimises the amount of air swallowed.
However, for various reasons (it could be a shallow latch, oral motor challenges, an uncoordinated suck, or even an overly fast milk flow) this sequence can get a bit out of sync. Instead of a smooth rhythm, you might see:
Suck-suck-swallow-gasp!: Too much air pulled in with the swallow.
Rapid, shallow sucking followed by gulping: Inefficient milk transfer and air intake.
Clicking noises during feeding: Loss of suction, indicating air entry.
Frequent detaching and re-latching: Often to ‘catch a breath’ or because of discomfort.
Each of these patterns can lead to increased air intake.
The root cause: Air trapping leading to a gassy breastfed baby
When a baby swallows too much air during a feed, that air must go somewhere. It builds up in the stomach, causing bloating, discomfort, and often leads to the familiar reflux-like symptoms parents describe: arching, spitting up, burping excessively, or simply appearing distressed.
It’s a common misconception that all gassiness or reflux symptoms in a breastfed baby are due to something in the mother’s diet or a genuine digestive disorder. While these can be factors, as an SLT, we first look at the mechanics of the feed. If a baby is constantly struggling to maintain a seal, sucking inefficiently, or having to gulp to keep up with flow, he or she is inevitably swallowing air. This air then creates pressure, which can push milk back up (silent reflux) or out (visible reflux).
Think of it like trying to drink through a straw with a hole in it. You’re sucking, but you’re also pulling in air, making it harder to get the liquid and leaving you with more bubbles in your stomach.
Why mechanical speech therapy assessment is key
This is where the distinction between a medical diagnosis (true gastro oesophageal reflux disease or GORD) and a functional feeding challenge becomes critical. A paediatrician will assess for medical causes and may prescribe medication to reduce stomach acid. This can be appropriate for severe cases of GORD.
However, if the primary issue is air being trapped due to a suboptimal suck-swallow pattern, medication only treats the symptom (acid burning) and not the root cause (air intake). This is precisely where a Speech and Language Therapist specialising in infant feeding comes in.
My role is to meticulously observe and assess your baby’s oral motor skills, latch, tongue function, and the efficiency of their SSB sequence. I look for subtle signs of inefficiency that contribute to excessive air swallowing.
Is the tongue elevating correctly to create suction?
Is the jaw stable, or is it excessively moving?
Is the latch deep enough to prevent air leaks?
Can the baby coordinate suck, swallow, and breathe without gasping?
By identifying these mechanical challenges, I can then implement targeted strategies to improve feeding efficiency and reduce air intake, often leading to a significant reduction in reflux-like symptoms and overall discomfort.
Strategies to optimise air management during breastfeeding
The good news is that many babies can learn to feed more efficiently with the right support. Here are some general strategies we might explore:
Optimise latch and position: A deep, asymmetric latch is crucial. Experiment with different positions that allow for a deeper latch and better head/neck alignment, such as laid-back feeding or upright positions.
Paced feeding (even at the breast): If your milk flow is very fast, consider removing your baby from the breast briefly if you hear excessive gulping or see him or her struggling to breathe. This allows him or her to catch up and manage the flow.
Support the jaw and cheeks: Sometimes, gentle support to the baby’s jaw or cheeks can help them maintain a more stable, efficient suck. I can demonstrate specific techniques for this.
Burping effectively: While burping won’t get rid of all swallowed air, upright burping positions and gentle back rubs can help release some of it.
Pre-feed oral preparation: Gentle oral massage or stretches before a feed can sometimes ‘wake up’ the oral muscles and improve coordination.
Addressing the ‘Great Air Debate’ isn’t about blaming anyone; it’s about empowering parents with a deeper understanding of their baby’s feeding mechanics. By focusing on the how, not just the what, we can often resolve persistent feeding challenges, reduce discomfort, and make breastfeeding a more joyful, peaceful experience for both you and your little one.
If you suspect your baby’s gassiness or reflux symptoms are related to how they are managing air during feeds, don’t hesitate to reach out for a specialist assessment.
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of The London Speech and Feeding Practice.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
For all children every milestone achieved is a testament to the unique and intricate process unfolding within each young mind. For autistic children, this journey may present a distinct pattern, with some reaching developmental milestones like crawling, walking, and talking later than their neurotypical peers. Let’s have a look into the fascinating realm of Autism and explore why some autistic children might crawl, walk, and talk later, shedding light on the underlying factors contributing to this unique way of developing.
1. Individual Pacing:
Child development is not a one-size-fits-all journey. Each child, whether neurotypical or autistic, has a unique timeline for achieving milestones. Autistic children, like any other children, follow their own pacing. This individual rhythm might lead them to focus on one set of skills before they progress to others. Like some neurotypical children might focus on talking earlier than walking, autistic children might prioritise other areas before crawling or talking.
2. Neurodevelopmental Complexity:
The human brain is a remarkable entity, with a bewildering array of interconnected processes that lead to us achieving our developmental milestones. Autistic children often have variations in “neural wiring”, which can impact the balance between gross motor skills (crawling, walking) and fine motor skills. Speech and language acquisition falls under fine motor skills and may be momentarily disrupted due to the divergent neurological pathways at play in autism.
2. Sensory Processing Differences:
One of the hallmarks of autism is altered sensory processing. Autistic children often experience sensory stimuli differently than their neurotypical peers. This heightened or diminished sensitivity can influence a child’s desire or ability to engage in activities like crawling and walking. The sensation of movement while crawling or walking, for instance, might be overwhelming for some autistic children, causing them to either avoid or delay these activities.
3. Visual-Spatial Abilities:
Autistic children and adults frequently display excellent visual-spatial abilities. This strength might lead some children to focus more on activities that engage these skills, potentially delaying their engagement with activities like walking or talking. As they navigate their environment and process information visually, they might naturally invest more time in activities that stimulate this particular cognitive ability and strength.
4. Communication Challenges:
For many autistic children, speaking can be a really complex and difficult endeavour. Communication delays are a common feature of autism. This can affect both receptive and expressive language development. While some children might be physically capable of crawling or walking, they may not yet have the tools to communicate their desires and intentions. This leads to a temporary focus on non-speaking forms of expression. This does not mean that they do not communicate at all. But autistic individuals often start out using jargoning or echolalia as a form of communication as well as behaviours and physical forms of communication.
5. Executive Functioning and Motor Skills:
Executive functioning, or abilities for planning, organising, and carrying out tasks, can vary in autistic children. These skills are crucial for activities like crawling, walking, and talking, which need coordination and planning. About 40% of autistic persons have a motor planning difficulty.
6. Intense Interests and Routines:
Autistic children often develop intense interests in specific subjects, sometimes to the exclusion of other activities. These interests might become their primary mode of engagement. They might side-line milestones like crawling, walking, or talking. The mostly rigid adherence to routines and preferences might cause them to allocate more time to their preferred activities. This delays their engagement with other developmental tasks.
How can Speech and Language Therapy help:
Support and Intervention:
Early intervention and regular Speech and Language Therapy play a pivotal role in the developmental journey of autistic children. Therapies tailored to individual needs can aid in bridging the gaps between milestones. Occupational therapy, for example, can help address sensory sensitivities and motor skill challenges that might impact crawling and walking. Speech therapy can help communication development, gradually bridging the gap between non-verbal expressions and spoken language.
For example, we now know that echolalia or jargoning of longer phrases with intonation, repeating scripts from favourite tv shows or songs have many meanings and communicative functions. For example, a child who utters long strings of echolalic utterances, often difficult to understand, might want to do any one of the following:
Comment
greet
ask a question
make a request
express surprise
negate something.
We now understand that the way to support a child with echolalia is to acknowledge all utterances and try and find out what the meaning is behind these scripts. This is very supportive. Over time it will lead a child to move on to understanding and saying more clear and self-generated language. For more information about this Natural Language Acquisition here are some other great websites for you to look at:
In conclusion, the journey of an autistic child’s development is a testament to the uniqueness and complexity of the human mind. The delays or differences in achieving milestones like crawling, walking, and talking can be attributed to a range of factors, including
neurodevelopmental intricacies,
sensory processing variations,
and communication challenges.
It’s crucial to recognise that these delays are not indicative of a lack of potential, but rather a manifestation of the intricate interplay between an autistic child’s strengths and challenges. By embracing these differences and providing tailored support, we can help each autistic child unfold their potential at their own pace.
Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive
Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
If you’re worried about your child’s speech, you are absolutely not alone. Many parents I work with tell me the same thing:
‘I’ve been Googling…’ ‘I asked ChatGPT what activities to try…’ ‘TikTok said we should practise this sound every day…’
It makes complete sense. When waiting lists are long, evenings are quiet, and your child is struggling to communicate, it’s natural to look for help wherever you can find it.
AI tools can actually be helpful in some ways. But they also have clear limits especially for children with significant speech delays or speech sound disorders.
Here’s an honest, balanced guide to what AI can do, and what it simply can’t.
✔️ What AI can help with
1. Explaining things in simple language
AI can be very helpful for explaining speech and language terms in a way that’s easy for parents to understand for example, what a phonological delay is, or what Childhood Apraxia of Speech means. It can also suggest possible reasons for a child’s speech delay based on the information you provide.
The difficulty is that parents (or teachers) can only ask questions based on what they notice or perceive to be the problem. In practice, this doesn’t always tell the full story. For example, parents often report that their child ‘can say certain words’, but during an assessment we may find those words are actually produced with consistent error patterns. These patterns give important clues about the underlying nature of the difficulty, whether it’s a delay or a disorder and they guide the speech therapist in choosing the most effective targets to improve intelligibility.
2. Suggesting games and activities
AI is very good at suggesting ideas for games and practice, such as word lists, simple play activities, sound practice games, book suggestions, and ways to encourage talking within everyday routines. These can be especially helpful when you feel stuck or want some fresh inspiration for supporting your child at home. It can help to think of AI as a big ideas bank, somewhere to dip into when you need new, playful ways to keep practice engaging.
3. Helping you prepare questions for a therapist
Some parents use AI to list questions before an assessment, understand reports and organise concerns.
This can make therapy feel less overwhelming and more collaborative.
Used this way, AI can actually support the therapy process.
❌ Where and why AI cannot replace real life speech therapy
There is substantial research supporting the effectiveness of real-life speech therapy compared to generic online resources or AI-generated suggestions. Here are some key points highlighting why in-person therapy is often more beneficial:
Personalisation: Speech therapists assess each child’s unique needs, strengths, and challenges through direct observation and interaction. This personalised approach allows for tailored interventions that address specific issues, which generic resources cannot provide.
Nuanced understanding: Therapists are trained to recognise subtle cues in speech production, including the nuances of sound articulation, language comprehension, and social communication. This expertise enables us to identify underlying issues that may not be apparent through generic assessments.
Motivational support: A speech therapist can provide encouragement, motivation, and emotional support, which can significantly enhance a child’s willingness to participate and engage in therapy. This relational aspect is crucial for building confidence and reducing anxiety around communication.
Evidence-based practices: As a highly trained and specialised speech therapist I utilise evidence-based practices that are grounded in research, ensuring that the techniques used are effective and up to date. This contrasts with generic online information, which may not always be reliable or validated.
Progress monitoring: In-person therapy allows for ongoing assessment and adjustments to the treatment plan. We track progress over time and modify strategies as needed, ensuring that the therapy remains effective and relevant.
Research studies consistently show that individualised, face-to-face interventions lead to better outcomes in speech therapy than generalised approaches. For parents and caregivers, seeking professional help tends to provide a more effective path toward improving their child’s communication skills.
The healthiest way to think about AI
AI works best as a starting point, not a substitute. You might use it to understand your child’s report and learn how speech develops,
But if your child has significant delay or difficulty being understood, what makes the real difference is:
A tailored assessment
A clear therapy plan
Expert target selection
Ongoing adjustment
Support for both child and you the parent!
Dear parents,
If you’ve been turning to AI for help, it doesn’t mean you’re doing anything wrong. It means you care!
But please know the best outcomes usually come from combining your daily support at home with guidance and support from your speech therapist who knows you and your child.
Many of my past and present clients tell me that they really value my ‘handholding’ and me guiding them in between the sessions. A quick check in is often all that is needed but it makes a huge difference!
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
When your baby reaches around 12 months, there is a lot going on developmentally. They are learning to walk, communicate, feed themselves and become increasingly independent. One small but important milestone that can sometimes get overlooked is learning to drink from an open cup.
Many toddlers continue to have milk from a bottle well beyond their first birthday, and parents are often understandably reluctant to take it away. The bottle may be familiar, comforting and convenient, particularly at bedtime.
But moving towards an open cup is not simply about changing the way your child drinks. It is part of their development of oral-motor skills, feeding independence and mealtime development.
And there is another piece of the puzzle that is often overlooked: how your toddler is sitting while they eat and drink.
The way the body is supported can make a real difference to what the mouth is able to do.
Babies can begin learning to drink from an open cup much earlier than many parents realise. By around 12 months, most children should be given regular opportunities to practise drinking from an open cup alongside other suitable drinking vessels.
An open cup encourages your toddler to learn a different pattern of drinking from the sucking pattern they have used with a bottle.
With an open cup, your child needs to:
lean towards the cup and control its position
grade how much liquid enters the mouth
use their lips to help control the liquid
coordinate breathing and swallowing
develop increasingly mature tongue and jaw movements
learn to take a drink without relying on a teat or nipple.
These are useful skills for developing efficient eating and drinking.
This doesn’t mean that a toddler who still has a bottle at 14 or 18 months has somehow ‘missed their chance’. Children develop at different rates, and there is always an opportunity to work towards new skills.
However, if a bottle remains the main or only way a child drinks for a long time, there can be fewer opportunities to practise these more mature drinking skills.
The occasional bottle is not the issue. The concern is when a toddler continues to rely heavily on a bottle and therefore has little reason or opportunity to develop other drinking skills.
A bottle encourages a sucking pattern which is appropriate for infancy. As children mature, we want to see increasing use of their lips, tongue, jaw and facial muscles in more sophisticated ways.
Long-term bottle use can also make the transition to an open cup more difficult simply because the child has become very accustomed to the bottle.
There can also be practical considerations around dental health, particularly when milk is offered frequently throughout the day or overnight.
For many toddlers, the bottle has also become associated with comfort, sleep or emotional regulation. This can make giving it up feel like a very big change for the whole family.
So rather than thinking, ‘The bottle has to disappear tomorrow’, think:
‘How can I gradually increase opportunities for open-cup drinking?’
Offer the open cup regularly at meals. Let your toddler experiment. Expect spills. Keep the amount of liquid small initially and provide plenty of encouragement.
Learning to drink is a skill. And skills need practice.
When we think about feeding, we naturally tend to focus on the mouth. We watch what the tongue is doing, whether a child chews, whether they cough or gag and what foods they accept.
But feeding is a whole-body activity.
Your child needs a stable body position before they can use their mouth efficiently.
Think about trying to drink from a cup while sitting on a wobbly stool with your feet dangling in the air. You would probably find it much easier if your body was well supported.
The same principle applies to toddlers.
A well-designed highchair such as a Tripp Trapp chair can provide a stable base when it is correctly adjusted for the individual child. Ideally, your toddler should have:
hips well supported
knees comfortably bent
feet resting firmly on a footplate
a stable pelvis and trunk
the table or tray at an appropriate height
This gives your child a solid foundation from which to move.
And that matters because stability in the body supports movement and control in the mouth.
I sometimes hear parents say, ‘He doesn’t need the footrest don’t worry about it (as I crouch down with my Allenn key to adjust the Tripp Trapp chair) but I always explain it is very important to have his feet supported. Dangling legs can make it much harder to maintain a stable sitting position.
When the feet are supported, your toddler can push gently through their feet and stabilise their pelvis and trunk. This can help them maintain a more organised position while eating and drinking.
They can then devote more attention to the job in front of them:
looking, reaching, grasping, chewing, swallowing and drinking.
This is particularly important for toddlers who are developing their chewing skills or who find mealtimes physically demanding.
Eating involves an extraordinary amount of coordination.
Your toddler is managing food in their hands, bringing it to their mouth, biting, chewing, moving food around with their tongue, forming a bolus and swallowing, often while simultaneously looking around, communicating and interacting with you.
Drinking from an open cup adds another layer of coordination.
Good postural support doesn’t teach a child to drink from a cup, but it can give them a much better physical foundation from which to practise the skill.
This is why, when I assess a toddler’s feeding, I don’t just look inside the mouth.
I also look at how the child is positioned.
Making open-cup drinking part of everyday life
You don’t need a complicated programme.
At meals, offer a small amount of water in an open cup. You can help your toddler hold the cup initially, tipping it gently towards their lips and allowing them to control the drinking as much as possible.
Some mess is completely normal!
You might also use a small, lightweight open cup that is easy for little hands to manage.
And remember that the goal is not to make every drink perfect. The goal is to give your child regular, positive opportunities to practise.
If your toddler is struggling with drinking, frequently coughing or choking, refusing cups, relying heavily on a bottle, or experiencing difficulties with chewing and eating, it is worth seeking professional advice from a Speech and Language Therapist with expertise in paediatric feeding.
The bigger picture
Open-cup drinking and good sitting are not two unrelated developmental skills.
They are part of the same picture.
A stable body provides a foundation for skilled movement. Skilled movement supports feeding. And feeding skills develop through practice and opportunity.
So as your toddler approaches and moves beyond their first birthday, think beyond simply asking, ‘How much milk are they drinking?’
Think about how they are drinking, how they are sitting, and what opportunities they have to develop the skills they will need as they grow.
And if you have a little one sitting beautifully at the table in a well-supported Tripp Trapp chair, remember: you’re not just creating a comfortable seat.
You’re creating a stable foundation for eating, drinking, learning and growing.
Do get in touch with me. I would love to hear from you and help your little one develop good sitting and drinking habits.
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of The London Speech and Feeding Practice.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
